Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | A125358 | CA |
Y | 207RI0011X | Interventional Cardiology | A125358 | CA |
NPI | 1083841720 |
---|---|
Provider Name | David Juhyuk Suk |
First Address | Costa Mesa, CA 92626-3068 |
Second Address | Anaheim, CA 92801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2009 |
Last Update Date | 11/11/2021 |